Health care bill teeters as GOP adds money to woo dissident senators

Robert F. Bukaty/Associated Press/File

Moderate Senator Susan Collins of Maine all but closed the door on supporting the teetering GOP health bill.

By Alan Fram
Associated Press
September 25, 2017

WASHINGTON (AP) — Top Republicans are adding money to their staggering effort to repeal the Obama health care law and say they’re pushing toward a climactic Senate faceoff this week. Yet their path to succeeding in their last-gasp effort has grown narrower, perhaps impossible.

GOP senators’ opposition to their party’s drive to scrap President Barack Obama’s Affordable Care Act swelled to lethal numbers Sunday. Moderate Sen. Susan Collins all but closed the door on supporting the teetering bill and conservative Sen. Ted Cruz said that ‘‘right now’’ he doesn’t back it.

President Donald Trump has pressed for a fresh vote, and White House legislative liaison Marc Short and Sen. Lindsey Graham, R-S.C., one of the measure’s sponsors, said Republicans would move toward a vote this week. Senate Majority Leader Mitch McConnell, R-Ky., has said he intends to consider the measure but hasn’t firmly committed to a vote.

The Congressional Budget Office was expected to release its analysis of the legislation early this week.

But the CBO, which is lawmakers’ nonpartisan fiscal analyst, has said that it doesn’t have time to determine the bill’s impact on coverage and premiums, major factors for some lawmakers deciding their votes. Instead, the office is expected to only detail its estimates of the measure’s effect on federal deficits.

A vote must occur this week for Republicans to have any chance of prevailing with their narrow Senate majority. Next Sunday, protections expire against a Democratic filibuster, bill-killing delays that Republicans lack the votes to overcome.

Already two GOP senators, Rand Paul of Kentucky and John McCain of Arizona, have said they oppose the legislation. All Democrats will vote against it. ‘‘No’’ votes from three of the 52 GOP senators would kill the party’s effort to deliver on its perennial vow to repeal ‘‘Obamacare’’ and would reprise the party’s politically jarring failure to accomplish that this summer.

In a late stab at attracting votes, Republicans were adding $14.5 billion to the measure including extra funds for states of dissenting GOP senators, according to documents obtained late Sunday by The Associated Press.

A chart Republicans circulated said the legislation’s grants would provide 14 percent more money for Arizona than under Obama’s law; 4 percent more for Kentucky; 49 percent more for Texas; 3 percent more for Alaska, home to undecided GOP Sen. Lisa Murkowski; and 43 percent more for Maine, home to Collins. Some extra money is specifically directed at sparsely populated states.

The numbers are misleading, partly because they omit GOP Medicaid cuts from clamping per-person spending caps on the program, said Matt House, spokesman for Senate Minority Leader Chuck Schumer, D-N.Y. In a statement, Schumer said the measure would ‘‘throw our health insurance system into chaos.’’

Collins’ criticisms included the bill’s cuts in the Medicaid program for low-income people and the likelihood that it would result in many losing health coverage and paying higher premiums.

‘‘It’s very difficult for me to envision a scenario where I would end up voting for this bill,’’ said Collins.

The conservative Cruz also voiced opposition, underscoring the bill’s problems with both ends of the GOP spectrum.

‘‘Right now, they don’t have my vote,’’ Cruz said at a festival in Austin, Texas. He suggested the measure doesn’t do enough to reduce premiums by allowing insurers to sell less comprehensive coverage than Obama’s law allows.

Paul said even though the bill transforms federal health care dollars into block grants that states would control, the GOP bill left too much of that spending intact.

McCain has complained that Republicans should have worked with Democrats in reshaping the country’s $3 trillion-a-year health care system and cited uncertainty over the bill’s impact on consumers.

Murkowski has remained uncommitted, saying she’s studying the bill’s impact on Alaska. Her state’s officials released a report Friday citing ‘‘unique challenges’’ and deep cuts the measure would impose on the state. She and Collins were the only Republicans who voted ‘‘no’’ on four pivotal votes on earlier versions of the GOP legislation in July.

The bill now in play would repeal much of the 2010 law, including its tax penalties on people who don’t buy insurance and on larger employers not offering coverage to workers. States could loosen coverage requirements under the law’s mandates, including prohibiting insurers from charging seriously ill people higher premiums and letting them sell policies covering fewer services.

It would eliminate Obama’s expansion of Medicaid and the subsidies the law provides millions of people to reduce their premiums and out of pocket costs, substituting block grants to states.

Collins was on CBS’ ‘‘Face the Nation’’ and CNN’s ‘‘State of the Union,’’ Graham appeared on ABC’s ‘‘This Week’’ and Paul was on NBC’s ‘‘Meet the Press,’’ and Short was on CBS, NBC and ‘‘Fox News Sunday.’’

Associated Press writer Catherine Lucey in Somerset, New Jersey, contributed to this report.